scholarly journals European views on patients directly obtaining their laboratory test results

2015 ◽  
Vol 53 (12) ◽  
Author(s):  
Ian D. Watson ◽  
Joanna Siodmiak ◽  
Wytze P. Oosterhuis ◽  
Joel Corberand ◽  
Per E. Jorgensen ◽  
...  
Keyword(s):  
Information Technologies ◽  
Clinical Chemistry ◽  
Information Age ◽  
Negative Attitude ◽  
Laboratory Medicine ◽  
European Federation ◽  
Test Results ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Changing Practices

AbstractMedicine is a highly professionalized endeavour, by tradition centred on the authority of physicians. Better education and the advent of the information age cater for increased demands on society in general and on health care in particular to enable people to make informed decisions regarding themselves. Participation in medical decisions requires informed knowledge which is hard to obtain without substantial and time consuming professional help.We performed a survey amongst the member organizations of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in order to investigate the recognition and preparedness of providing help to patients in interpreting their laboratory results.Out of 40 EFLM Member Societies, 27 sent their responses to the survey. In most cases the first line delivery of laboratory results to physicians is by computer link (63%). Patients receive their laboratory results on demand from their physician in 60% of cases. However, 34% of laboratory specialists showed a negative attitude for delivering laboratory results to patients. Yet, in 48% of countries 1–5 patients per day ask a laboratory specialist about the significance of laboratory results outside the reference range. When patients are informed about the purpose of laboratory testing, they seek information primarily from their physician, followed by the internet and the Specialist in Laboratory Medicine.Changing practices increasingly enabling patient access to their records are on the increase facilitated by recent innovations in information technologies. Successful transfer of some of the responsibilities of physicians, demands a mutual triangular dialogue between the patient, their physician and laboratory medicine.

scholarly journals Adding clinical utility to the laboratory reports: automation of interpretative comments

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Wytze Oosterhuis
Keyword(s):  
Clinical Chemistry ◽  
Patient Empowerment ◽  
High Volume ◽  
Laboratory Medicine ◽  
Patient Treatment ◽  
Patient Specific ◽  
European Federation ◽  
Diagnostic Efficiency ◽  
Laboratory Test Results ◽  
Interpretative Comments

Abstract In laboratory medicine, consultation by adding interpretative comments to reports has long been recognized as one of the activities that help to improve patient treatment outcomes and strengthen the position of our profession. Interpretation and understanding of laboratory test results might in some cases considerably be enhanced by adding test when considered appropriate by the laboratory specialist – an activity that was named reflective testing. With patient material available at this stage, this might considerably improve the diagnostic efficiency. The need and value of these forms of consultation have been proven by a diversity of studies. Both general practitioners and medical specialists have been shown to value interpretative comments. Other forms of consultation are emerging: in this time of patient empowerment and shared decision making, reporting of laboratory results to patients will be common. Patients have in general little understanding of these results, and consultation of patients could add a new dimension to the service of the laboratory. These developments have been recognized by the European Federation of Clinical Chemistry and Laboratory Medicine, which has established the working group on Patient Focused Laboratory Medicine for work on the matter. Providing proper interpretative comments is, however, labor intensive because harmonization is necessary to maintain quality between individual specialists. In present-day high-volume laboratories, there are few options on how to generate high-quality, patient-specific comments for all the relevant results without overwhelming the laboratory specialists. Automation and application of expert systems could be a solution, and systems have been developed that could ease this task.

Quality benchmarking of smartphone laboratory medicine applications: comparison of laboratory medicine specialists’ and non-laboratory medicine professionals’ evaluation

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Snežana Jovičić ◽  
Joanna Siodmiak ◽  
Marta Duque Alcorta ◽  
Maximillian Kittel ◽  
Wytze Oosterhuis ◽  
...  
Keyword(s):  
Information Quality ◽  
Rating Scale ◽  
Laboratory Medicine ◽  
Test Results ◽  
Content Quality ◽  
Laboratory Test Results ◽  
System Usability Scale ◽  
Mobile Health Applications ◽  
Fit For Purpose ◽  
Health Applications

AbstractObjectivesThere are many mobile health applications (apps) now available and some that use in some way laboratory medicine data. Among them, patient-oriented are of the lowest content quality. The aim of this study was to compare the opinions of non-laboratory medicine professionals (NLMP) with those of laboratory medicine specialists (LMS) and define the benchmarks for quality assessment of laboratory medicine apps.MethodsTwenty-five volunteers from six European countries evaluated 16 selected patient-oriented apps. Participants were 20–60 years old, 44% were females, with different educational degrees, and no professional involvement in laboratory medicine. Each participant completed a questionnaire based on the Mobile Application Rating Scale (MARS) and the System Usability Scale, as previously used for rating the app quality by LMS. The responses from the two groups were compared using the Mann-Whitney U test and Spearman correlation.ResultsThe median total score of NLMP app evaluation was 2.73 out of 5 (IQR 0.95) compared to 3.78 (IQR 1.05) by the LMS. All scores were statistically significantly lower in the NLMP group (p<0.05), except for the item Information quality (p=0.1631). The suggested benchmarks for a useful appear: increasing awareness of the importance and delivering an understanding of persons’ own laboratory test results; understandable terminology; easy to use; appropriate graphic design, and trustworthy information.ConclusionsNLMP’ evaluation confirmed the low utility of currently available laboratory medicine apps. A reliable app should contain trustworthy and understandable information. The appearance of an app should be fit for purpose and easy to use.

Flexible scope for ISO 15189 accreditation: a guidance prepared by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group Accreditation and ISO/CEN standards (WG-A/ISO)

2015 ◽  
Vol 53 (8) ◽  
Author(s):  
Marc H.M. Thelen ◽  
Florent J.L.A. Vanstapel ◽  
Christos Kroupis ◽  
Ines Vukasovic ◽  
Guilaime Boursier ◽  
...  
Keyword(s):  
Working Group ◽  
Clinical Chemistry ◽  
Laboratory Medicine ◽  
Position Paper ◽  
European Federation ◽  
Medical Field ◽  
Iso 15189 ◽  
Medical Laboratories ◽  
Flexible Scope ◽  
Scientific Disciplines

AbstractThe recent revision of ISO15189 has further strengthened its position as the standard for accreditation for medical laboratories. Both for laboratories and their customers it is important that the scope of such accreditation is clear. Therefore the European co-operation for accreditation (EA) demands that the national bodies responsible for accreditation describe the scope of every laboratory accreditation in a way that leaves no room for doubt about the range of competence of the particular laboratories. According to EA recommendations scopes may be fixed, mentioning every single test that is part of the accreditation, or flexible, mentioning all combinations of medical field, examination type and materials for which the laboratory is competent. Up to now national accreditation bodies perpetuate use of fixed scopes, partly by inertia, partly out of fear that a too flexible scope may lead to over-valuation of the competence of laboratories, most countries only use fixed scopes. The EA however promotes use of flexible scopes, since this allows for more readily innovation, which contributes to quality in laboratory medicine. In this position paper, the Working Group Accreditation and ISO/CEN Standards belonging to the Quality and Regulation Committee of the EFLM recommends using an approach that has led to successful introduction of the flexible scope for ISO15189 accreditation as intended in EA-4/17 in The Netherlands. The approach is risk-based, discipline and competence-based, and focuses on defining a uniform terminology transferable across the borders of scientific disciplines, laboratories and countries.

scholarly journals Utilisation of laboratory test results for patient management by clinicians at two large referral hospitals in Zambia

2020 ◽  
Author(s):  
Sabe Mwape ◽  
Victor Daka ◽  
Scott Matafwali ◽  
Kapambwe Mwape ◽  
Jay Sikalima ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Laboratory Tests ◽  
Patient Management ◽  
Medical Laboratory ◽  
Test Results ◽  
Cross Sectional ◽  
Childrens Hospital ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Referral Hospitals

Background Medical laboratory diagnosis is a critical component of patient management in the healthcare setup. Despite the availability of laboratory tests, clinicians may not utilise them to make clinical decisions. We investigated utilsation of laboratory tests for patient management among clinicians at Ndola Teaching Hospital (NTH) and Arthur Davison Childrens Hospital (ADCH), two large referral hospitals in the Copperbelt Province, Ndola, Zambia. Method We conducted a descriptive cross-sectional study among clinicians. The study deployed self-administered questionnaires to evaluate clinician utilisation, querying and confidence in laboratory results. Additional data on demographics and possible laboratory improvements were also obtained. Data were entered in Microsoft excel and exported to SPSS version 16 for statistical analysis. Results Of the 80 clinicians interviewed, 96.2% (77) reported using laboratory tests and their results in patient management. 77.5% (62) of the clinicians indicated they always used laboratory results to influence their patient management decisions. Of the selected laboratory tests, clinicians were more confident in using haemoglobin test results (91.2%). There was no statistically significant association between the clinicians gender or qualification and use of test results in patient management. Conclusion Our findings show that despite the majority querying laboratory results, most of the clinicians use laboratory results for patient management. There is need for interactions between the laboratory and clinical area to assure clinician confidence in laboratory results. Key words: utilisation, clinicians, laboratory tests, Ndola Teaching Hospital, Arthur Davison Childrens Hospital

scholarly journals Knowledge and attitudes of Saudi medical laboratory professionals concerning non-pathological factors influencing test results

2021 ◽  
Vol 3 (3) ◽  
pp. 234-240
Author(s):  
Mohammed Makkawi ◽  
Keyword(s):  
Health Management ◽  
Healthcare Services ◽  
Medical Laboratory ◽  
Test Results ◽  
Medical Decisions ◽  
Knowledge And Attitudes ◽  
Laboratory Test Results ◽  
Laboratory Results ◽  
Patient Health ◽  
Medical Laboratory Professionals

Introduction: Successful medical decisions are highly reliant on medical laboratory results; as such, laboratory results are essential to patient health management, and errors in those results may lead to serious complications and death. The aim of the present study was to assess the knowledge of medical laboratory practitioners in Saudi Arabia regarding factors that may influence medical laboratory testing results and the correct actions for troubleshooting. Methods: A total of 256 practitioners participated, representing diverse qualifications and various healthcare sectors. The study utilized a pretested questionnaire comprised of three sections: socio-demographic characteristics, knowledge, and attitudes. Results: The responses demonstrated participants to possess outstanding knowledge of factors that may affect laboratory test results, including biological and pathological factors, diet, and personal habits. Furthermore, participants demonstrated satisfactory attitudes toward such factors. Conclusions: Thus, this study reveals a magnificent image concerning Saudi practitioners’ knowledge and capacity for suitable actions given unexpected test results, and hence their ability to provide correct healthcare services. This constitutes an acceptable overview, particularly as a first pass; nonetheless, more studies on larger cohorts remain required.

scholarly journals An overview of EFLM harmonization activities in Europe

2018 ◽  
Vol 56 (10) ◽  
pp. 1591-1597 ◽  
Author(s):  
Eric S. Kilpatrick ◽  
Sverre Sandberg
Keyword(s):  
Best Practice ◽  
Clinical Chemistry ◽  
Laboratory Medicine ◽  
Biological Variation ◽  
European Federation ◽  
Eu Countries ◽  
European Guidelines ◽  
Common Basis ◽  
Evaluation Procedures ◽  
E Learning

Abstract The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has initiated many harmonization activities in all phases of the examination process. The EFLM is dealing with both the scientific and the educational aspects of harmonization, with the intention of disseminating best practice in laboratory medicine throughout Europe. Priorities have been given (1) to establish a standard for conducting and assessing biological variation studies and to construct an evidence based EFLM webpage on biological variation data, (2) to harmonize preanalytical procedures by producing European guidelines, (3) to improve test ordering and interpretation, (4) to produce other common European guidelines for laboratory medicine and play an active part in development of clinical guidelines, (5) to establish a common basis for communicating laboratory results to patients, (6) to harmonize units of measurement throughout Europe, (7) to harmonize preanalytical procedures in molecular diagnostics and (8) to harmonize and optimize test evaluation procedures. The EFLM is also now launching the 5th version of the European Syllabus to help the education of European Specialists in Laboratory Medicine (EuSpLM), which is being supported by the development of e-learning courses. A register of EuSpLM is already established for members of National Societies in EU countries, and a similar register will be established for specialists in non-EU countries.

Herbal Remedies: Effects on Clinical Laboratory Tests

2006 ◽  
Vol 130 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Amitava Dasgupta ◽  
David W. Bernard
Keyword(s):  
Chinese Medicine ◽  
Laboratory Test ◽  
Alternative Medicine ◽  
Clinical Laboratory ◽  
Herbal Remedies ◽  
Test Results ◽  
Abnormal Laboratory ◽  
St John's Wort ◽  
Laboratory Test Results ◽  
Laboratory Results

AbstractContext.—Complementary and alternative medicine (herbal medicines) can affect laboratory test results by several mechanisms.Objective.—In this review, published reports on effects of herbal remedies on abnormal laboratory test results are summarized and commented on.Data Sources.—All published reports between 1980 and 2005 with the key words herbal remedies or alternative medicine and clinical laboratory test, clinical chemistry test, or drug-herb interaction were searched through Medline. The authors' own publications were also included. Important results were then synthesized.Data Synthesis.—Falsely elevated or falsely lowered digoxin levels may be encountered in a patient taking digoxin and the Chinese medicine Chan Su or Dan Shen, owing to direct interference of a component of Chinese medicine with the antibody used in an immunoassay. St John's wort, a popular herbal antidepressant, increases clearance of many drugs, and abnormally low cyclosporine, digoxin, theophylline, or protease inhibitor concentrations may be observed in a patient taking any of these drugs in combination with St John's wort. Abnormal laboratory results may also be encountered owing to altered pathophysiology. Kava-kava, chaparral, and germander cause liver toxicity, and elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin concentrations may be observed in a healthy individual taking such herbal products. An herbal product may be contaminated with a Western drug, and an unexpected drug level (such as phenytoin in a patient who never took phenytoin but took a Chinese herb) may confuse the laboratory staff and the clinician.Conclusions.—Use of alternative medicines may significantly alter laboratory results, and communication among pathologists, clinical laboratory scientists, and physicians providing care to the patient is important in interpreting these results.

scholarly journals Personalized Reference Intervals in Laboratory Medicine: A New Model Based on Within-Subject Biological Variation

2020 ◽  
Author(s):  
Abdurrahman Coşkun ◽  
Sverre Sandberg ◽  
Ibrahim Unsal ◽  
Coskun Cavusoglu ◽  
Mustafa Serteser ◽  
...  
Keyword(s):  
Steady State ◽  
Personalized Medicine ◽  
Clinical Chemistry ◽  
Reference Interval ◽  
Reference Intervals ◽  
Biological Variation ◽  
Test Results ◽  
Steady State Condition ◽  
Laboratory Test Results ◽  
Measurement Results

Abstract Background The concept of personalized medicine has received widespread attention in the last decade. However, personalized medicine depends on correct diagnosis and monitoring of patients, for which personalized reference intervals for laboratory tests may be beneficial. In this study, we propose a simple model to generate personalized reference intervals based on historical, previously analyzed results, and data on analytical and within-subject biological variation. Methods A model using estimates of analytical and within-subject biological variation and previous test results was developed. We modeled the effect of adding an increasing number of measurement results on the estimation of the personal reference interval. We then used laboratory test results from 784 adult patients (&gt;18 years) considered to be in a steady-state condition to calculate personalized reference intervals for 27 commonly requested clinical chemistry and hematology measurands. Results Increasing the number of measurements had little impact on the total variation around the true homeostatic set point and using ≥3 previous measurement results delivered robust personalized reference intervals. The personalized reference intervals of the study participants were different from one another and, as expected, located within the common reference interval. However, in general they made up only a small proportion of the population-based reference interval. Conclusions Our study shows that, if using results from patients in steady state, only a few previous test results and reliable estimates of within-subject biological variation are required to calculate personalized reference intervals. This may be highly valuable for diagnosing patients as well as for follow-up and treatment.

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